High plasma soluble CLEC-2 level predicts oxygen therapy requirement in patients with COVID-19

Figures & data

Table I. Patient characteristics, clinical course, and outcomes.

	Oxygen administration during hospitalization
	All patients (n = 108)	No (unoxygenated group) (n = 57)	Yes (oxygenated group) (n = 51)	P-value
Age, years	54.5 (13–94)	46 (13–94)	60 (19–89)	.0451
Sex
Male	63 (58.3)	32 (56.1)	31 (60.8)
Female	45 (41.7)	25 (43.9)	20 (105.3)	.6975
Comorbidity
COPD	9 (8.3)	3 (5.3)	6 (11.8)	.302
Diabetes	21 (19.4)	7 (12.3)	14 (27.5)	.0547
Hypertension	35 (32.4)	16 (28.1)	19 (37.3)	.4104
Coronary heart disease	9 (8.3)	6 (10.5)	3 (5.9)	.4953
Cerebrovascular disease	4 (3.7)	2 (3.5)	2 (3.9)	1
Cancer	17 (15.7)	12 (21.1)	5 (9.8)	.122
CKD	13 (12.0)	8 (14.0)	5 (9.8)	.5648
Dyslipidemia	20 (18.5)	8 (14.0)	12 (23.5)	.2248
Drug
Antiplatelet	10 (9.3)	5 (8.8)	5 (9.8)	1
Anticoagulant	9 (8.3)	5 (8.8)	4 (7.8)	1
Events during hospitalization
Admission to ICU	3 (2.8)	0 (0)	3 (5.9)
ECMO support	3 (2.8)	0 (0)	3 (5.9)
Macrothrombosis	1 (0.9)	0 (0)	1 (2.0)
Duration of hospitalization, days	10 (2–51)	8 (2–49)	13 (7–51)	<.0001
Outcome
No change	4 (3.7)	4 (7.0)	0 (0)
Recovery	100 (92.6)	53 (93.0)	47 (92.2)
Death	4 (3.7)	0 (0)	4 (7.8)

Age and duration of hospitalization in median (range); other data are presented as numbers (%).

Abbreviations: COPD, chronic obstructive pulmonary disease; CKD, chronic kidney disease; ICU, intensive care unit; ECMO, extracorporeal membrane oxygenation.

Table II. Blood test findings on admission.

	Oxygen administration during hospitalization
	No (unoxygenated group) (n = 57)	Yes (oxygenated group) (n = 51)	P-value
WBC (/µL)	4890 (1640–15020)	4950 (1490–29030)	.2926
Lymphocyte (/µL)	1015 (340–2870)	780 (190–3870)	.0175
Neutrocyte (/µL)	3010 (980–13100)	3635 (480–14880)	.0152
RBC (×10⁶/µL)	4.52 (2.31–6.26)	4.65 (2.7–6.78)	.348
Plt (×10⁴/µL)	19.9 (0.6–185)	17.9 (6.9–49)	.5424
MPV (fL)	10.15 (9.5–11.5)	10.4 (7.6–12.1)	.5148
PDW (%)	11.4 (9.7–14.1)	11.9 (7–15.2)	.3945
CRP (µg/mL)	0.80 (0.1–8.74)	4.51 (0.1–32.67)	<.0001
D-dimer (µg/mL)	0.6 (0.5–43.3)	1.0 (0.5–6.4)	.1236
FDP (µg/mL)	4.5 (2.5–86.1)	6.0 (2.7–12.8)	.0486
PT (%)	91.6 (29.7–121.3)	89.0 (36.8–121.3)	.6268
APTT (s)	32.2 (26.9–46.4)	34.2 (26.4–117.1)	.0631
Fibrinogen (mg/dL)	359.5 (166–676)	492 (258–1275)	.0002
TP (g/dL)	7.15 (5.9–8.5)	6.6 (5.4–7.6)	.0001
Alb (g/dL)	4.0 (3–5.1)	3.4 (2–4.4)	<.0001
ChE (U/L)	292 (115–580)	259 (119–487)	.0642
ALP (U/L)	83 (45–276)	73.5 (37–238)	.112
γ-GT (U/L)	25 (5–1615)	41 (12–503)	.0129
LDH (U/L)	208.5 (121–443)	331 (125–801)	<.0001
AST (U/L)	24 (13–185)	41 (16–170)	<.0001
ALT (U/L)	18 (8–139)	29 (9–228)	.0027
BUN (mg/dL)	14.2 (3.5–89.6)	14.4 (5.5–93.2)	.8632
Cre (mg/dL)	0.79 (0.13–8.8)	0.78 (0.41–13.27)	.9926
UA (mg/dL)	4.9 (1.8–7.9)	4.3 (1.8–14)	.0131
CK (U/L)	84 (25–355)	74 (11–979)	.3708
Amy (U/L)	64 (28–616)	65 (27–192)	.4863
Procalcitonin (mg/mL)	0.04 (0.02–1.01)	0.07 (0.02–1.84)	.003
HbA1c (%)	5.6 (4.7–7.9)	5.95 (4.9–8.5)	.009
sCLEC-2 (pg/mL)	188.8 (42.4–480.3)	296.1 (66.9–759.1)	<.0001
TM (U/mL)	15.3 (5.1–68.4)	14.2 (6.4–71.6)	.4926
VWF (%)	170 (84–400)	198 (79–374)	.0068
IL-6 (pg/mL)	6.5 (0.6–302.5)	21.1 (0.6–212.2)	<.0001
cfDNA (ng/mL)	179.5 (101.4–814.0)	254 (102.4–913.5)	<.0001
PAI-1	28 (10–204)	44 (17–181)	<.0001
sP-sel	31.7 (9.4–93)	31.9 (10.8–110.4)	.5734

Data are presented as the median (range).

Abbreviations: WBC, white blood cell; RBC, red blood cell; Plt, platelet; MPV, mean platelet volume; PDW, platelet distribution width; CRP, C-reactive protein; FDP, fibrin/fibrinogen degradation products; PT, prothrombin time; APTT, activated partial thromboplastin time; TP, total protein, Alb, albumin; ChE, choline esterase; ALP, alkaline phosphatase; γ-GT, γ-glutamyl transpeptidase; LDH, lactate dehydrogenase; AST, aspartate aminotransferase; ALT, alanine aminotransferase; BUN, blood urea nitrogen; Cre, creatinine; UA, urinary acid; CK, creatine kinase; Amy, amylase; HbA1c, glycated hemoglobin; sCLEC-2, soluble C-type lectin-like receptor 2; TM, thrombomodulin; VWF, von Willebrand factor; IL-6, interleukin-6; cfDNA, cell-free DNA; PAI-1, plasminogen activator inhibitor-1; sP-sel, soluble P-selectin.

Table III. Predictive factors for the requirement of oxygen administration, according to univariate and multivariate logistic regression analysis.

	Univariate		Multivariate
	Odds ratio (95% CI)	P-value	Odds ratio (95% CI)	P-value
Lymphocyte (OR per 100 units)	0.93 (0.86–1.00)	.0486	0.79 (0.63–0.98)	.0344
CRP	1.45 (1.21–1.74)	<.0001	1.61 (0.97–2.69)	.0670
D-dimer	0.96 (0.86–1.07)	.4389	0.92 (0.77–1.10)	.3366
LDH (OR per 10 units)	1.13 (1.07–1.20)	<.0001	0.96 (0.82–1.13)	.6348
HbA1c	2.69 (0.98–7.35)	.0543	3.30 (0.46–23.5)	.3447
sCLEC-2 (OR per 10 units)	1.10 (1.05–1.15)	.0001	1.25 (1.05–1.49)	.0119

Abbreviations: CRP, C-reactive protein; LDH, lactate dehydrogenase; HbA1c, glycated hemoglobin; sCLEC-2, soluble C-type lectin-like receptor 2; OR, odds ratio; CI, confidence interval.

Figure 1. Correlations of sCLEC-2 with other clinical and laboratory parameters.

The graph depicts the absolute value of Spearman’s correlation coefficient between sCLEC-2 and each parameter. The red (positive correlation coefficient) and blue bars (negative correlation coefficient) indicate P < .05. The severity at the time of sCLEC-2 measurement was scored 1-5 points (1, asymptomatic; 2, mild disease; 3, moderate disease I; 4, moderate disease II; and 5, severe disease).